Frequent visits to a French psychiatric emergency service: diagnostic variability in psychotic disorders

Psychiatr Serv. 2011 Aug;62(8):966-70. doi: 10.1176/ps.62.8.pss6208_0966.

Abstract

Objective: This study examined characteristics of frequent visitors to a psychiatric emergency service in a French public teaching hospital over six years. Diagnostic variability of psychotic disorders was documented.

Methods: A retrospective review of the service's administrative and medical databases identified 1,285 patients with more than one visit during the period who were given at least one diagnosis of a psychotic disorder. A total of 317 patients with six or more visits (frequent visitors) were compared with 968 patients with between two and five visits (occasional visitors).

Results: Frequent visitors were significantly more likely to be single and homeless and to have diagnostic variability, substance use disorders, and personality disorders. A total of 177 patients experienced diagnostic variability, which was found mainly in three diagnostic categories: schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features.

Conclusions: Future studies should further examine the link between increased use of emergency services and diagnostic variability.

MeSH terms

  • Adult
  • Age Factors
  • Bipolar Disorder / therapy
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • France
  • Hospitals, Psychiatric / statistics & numerical data*
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Ill-Housed Persons
  • Male
  • Marital Status
  • Multivariate Analysis
  • Psychotic Disorders / therapy*
  • Retrospective Studies
  • Schizophrenia / therapy